Organization
PETERKIN AND ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICE D. SMITH ED.D. (EXECUTIVE DIRECTOR)
(910) 323-1817
Entity
Organization
Contact information
Practice address
212 E. WALNUT STREET, GOLDSBORO, NC 27530-4835
(919) 739-5637
(919) 739-5636
Mailing address
131 HAY STREET,, SUITE 201, FAYETTEVILLE, NC 28301-5649
(910) 323-1817
(910) 323-2607
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NC
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8302051
—
NC
05
—
8302051A
—
NC
05
—
8302051B
—
NC
Enumeration date
03/16/2007
Last updated
12/04/2009
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